Relationship Between Presence of a Reported Medical Home and Emergency Department Use Among Children With Asthma

South Carolina Public Health Consortium, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Suite 309, Columbia, SC 29208, USA.
Medical Care Research and Review (Impact Factor: 2.62). 05/2010; 67(4):450-75. DOI: 10.1177/1077558710367735
Source: PubMed


This study examined data from the 2005-2006 National Survey of Children with Special Health Care Needs to assess the relationship among children with asthma between a reported medical home and emergency department (ED) use. The authors used 21 questions to measure 6 medical home components: personal doctor/nurse, family-centered, compassionate, culturally effective and comprehensive care, and effective care coordination. Weighted zero-inflated Poisson regression analyses assessed the independent effects of having a medical home on annual number of child ED visits while controlling for child and parental characteristics, and the differential likelihood of securing a medical home. Nearly half (49.9%) of asthmatic children had a medical home. Receiving primary care in a medical home was associated with fewer ED visits (incidence rate ratio = 0.93; 95% confidence interval = 0.89-0.97). A medical home in which physicians and parents share responsibility for ensuring that children have access to needed services may improve child and family outcomes for children with asthma.

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Available from: James Hardin, Mar 26, 2014
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    • "However, the patient experience survey data relied on a 20% response rate, making it impossible to know whether that deterioration was real. Both Roby et al. (2010) and Diedhiou et al. (2010) reported fewer emergency department visits among patients receiving care in a medical home, but in neither case was it clear that the comparison group was similar to the intervention group in these observational studies. These and earlier studies are suggestive , as are international comparisons, but a skeptic would like more convincing evidence before accepting medical homes as the solution to our health care problems. "
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